Hand problems Flashcards
What is a mucous cyst?
outpouching of synovial fluid from DIP joint
may deform the nail and cause a ridge and discharge
painful
can be excised or left alone
What is a ganglion?
outpouching of the synovial cavity
resolved with excising or aspirate
What is trigger finger?
swelling of tendons in the tendon sheath causing the tendon to get caught on the edge of the A1 pulley (usually in flexion)
What are the examination findings for trigger finger?
feel the nodule pass beneath the pulley usually in flexion, it makes a clicking sound
What is the mangement of trigger finger?
can resolve spontaneously
splint
give steroid injections into tendon sheath - can cure
surgery to divide A1 pulley
What fingers are most commonly affected by trigger finger?
middle finger
ring finger
What is DeQuervians Tenosynovitis?
painful, red, swollen thumb
comes on spontaneously due to inflammation of tendons a the side of the wrist and base of the thumb
How is DeQuervians Tenosynovitis diagnosed?
Finklesteins test
Ultrasound
How is DeQuervians Tenosynovitis managed?
rest - splint
NSAIDs
steroid injections
decompression
Who is more likely to get DeQuervians Tenosynovitis: males or females?
females
What is Dupuytrens contracture?
thickening and contracture of the subepidermal fascia, leading to a fixed flexion deformity of the fingers
it is an avascular process involving O2 free radicals
What type of collagen is laid down in Dupuytrens contracture?
type 3 collagen
How does Dupuytrens contracture present?
starts: palmar pit nodule then progresses to a fixed flexion deformity
normally males
What is Dupuytrens contracture due to?
genetics alcohol - cirrhosis diabetes smoking epilepsy
What is the examination for Dupuytrens contracture?
table top test
examine/feel hands
What is the treatment for Dupuytrens contracture?
stretches
surgery - segmental fasiectomy, amputation, dermofasciectomy
collagenase injections
What is a paronychia?
an infection within the nail fold commonly seen in children due to nail biting - results in pus
What is the treatment for paronychia?
antibiotics
incise and drain collection
elevate
What is a flexor tendon sheath infection?
EMERGENCY
tracts up the arm, extremely painful
What is the management of a flexor tendon sheath infection?
wash out the tendon sheath
What are the side effects of a flexor tendon sheath infection?
lymphangitis
limited extension of arm
What is a mallet finger caused by?
an avulsion fracture
What is the treatment of mallet finger?
splint for 6 weeks
dermatotendesis in chronic cases
Why do PIP dislocations need to be treated acutely?
need to be reduced acutely otherwise it will need fusion
What is Eschar?
thick, leathery skin that forms after burns and requires surgical release
What sign does wrist instability present with?
Terry thomas sign on Xray - scapoid lunate ligament rupture
- treated with 4 corner fusion and proximal row carpectomy or total wrist arthrodesis
What is the presentation of swan neck deformity?
HYPEREXTENDED pip
flexed dip
What is the presentation of boutonniere deformity?
flexed pip
HYPEREXTENDED dip
What causes a boutonniere deformity?
extensor hood of PIP becomes attenuated meaning that the slips of the extensor tendon moves from dorsal -> volar -> centre of rotation causing flexion of the PIP and the middle phalange buttonholes through the extensor hood
How is boutonniere and swan neck deformities treated?
splint and tendon reposition
